A nurse is caring for a patient with increased cholesterol, hypertension, and Type I Diabetes Mellitus. The dietician comes in with the nurse to discuss an appropriate diet with the patient. Which fats will the dietician most likely encourage the patient to limit?

Choice A reason: This response dismisses the patient’s anxiety by offering superficial reassurance without addressing their emotional state. Preoperative anxiety activates the sympathetic nervous system, increasing cortisol and adrenaline, which disrupt sleep by elevating heart rate and alertness. This approach fails to validate emotions, potentially worsening stress responses and hindering psychological coping, making it non-therapeutic for addressing the patient’s distress.

Choice B reason: Questioning the patient’s insomnia and implying they should feel reassured invalidates their feelings. Anxiety triggers the hypothalamic-pituitary-adrenal axis, releasing stress hormones that disrupt REM sleep cycles. This response lacks empathy, failing to address the limbic system’s role in emotional distress, which is critical for therapeutic communication to reduce preoperative anxiety and promote emotional stability.

Choice C reason: Minimizing the patient’s concerns and focusing on pharmacological intervention ignores emotional needs. Sedatives may depress the central nervous system to induce sleep, but they don’t address anxiety-driven amygdala activation, which elevates cortisol. A therapeutic response should validate feelings and offer emotional support to mitigate stress responses, making this option inadequate for addressing the patient’s psychological state.

Choice D reason: This empathetic response acknowledges the patient’s uncertainty and invites dialogue, aligning with therapeutic communication principles. Preoperative anxiety, driven by fear of unknown surgical outcomes, activates the limbic system, increasing heart rate and cortisol. By validating emotions and offering support, this response fosters trust, reduces stress hormone release, and supports psychological coping, making it the most appropriate choice.

Choice A reason: Ensuring the patient receives all necessary information is the physician’s responsibility, not the nurse’s. Informed consent involves explaining risks, benefits, and alternatives, impacting patient autonomy. The nurse’s role is to witness the consent, verifying the patient’s understanding and voluntary agreement, ensuring ethical and legal standards are met without delivering medical details.

Choice B reason: Assessing competence is typically the physician’s role, as it requires evaluating cognitive capacity, influenced by neurological or psychological factors. Nurses may observe mental status but do not formally determine competence. Witnessing consent ensures the patient’s voluntary agreement, aligning with ethical principles of autonomy, making this a secondary nursing responsibility.

Choice C reason: Giving a complete procedure description is the surgeon’s duty, as it requires detailed medical knowledge of risks and outcomes. Nurses reinforce education but focus on witnessing consent to confirm voluntary agreement. Providing medical details exceeds the nurse’s scope, potentially causing confusion or miscommunication, impacting the patient’s informed decision-making process.

Choice D reason: Witnessing informed consent is the nurse’s primary role, verifying the patient received and understood information from the physician and consents voluntarily. This upholds autonomy, ensuring the patient’s decision aligns with their values. The nurse’s signature confirms the process, protecting legal and ethical standards without requiring them to provide medical explanations.

Choice E reason: Researching non-surgical alternatives is outside the nurse’s scope during preoperative teaching. Physicians discuss treatment options, considering cancer stage and biology. Nurses focus on witnessing consent, ensuring the patient’s understanding and voluntary agreement, supporting autonomy without delving into medical research, which could delay or confuse the consent process.